Editorial: Connecticut lawmakers should continue fight to end facility fees

Published 7:45 pm, Tuesday, January 12, 2016

The fees charged by hospitals have long been shrouded in mystery, but as the cost of health care escalates and large health systems buy and control multiple hospitals and physician practices, the facility fees they charge are under intense scrutiny.

In fact, lawmakers and health care advocates are fighting to either cap or get rid of them.

And well they should.

Hospitals in Connecticut are gobbling up private physician practices faster than Pac-Man gobbled up dots, and an already costly system is becoming more expensive. As hospitals narrowed the choices of where residents can get medical services, they tacked on a facility fee not just for services provided in hospitals, but also by outpatient care centers and doctors’ offices.

Blindsided and confused, some patients are experiencing a heaping dose of anger when they open a bill from a hospital that bought out their private physician’s practice and see additional charges that can range from $100 up to $1,000.

The only thing that changed was that their doctor’s office is now hospital-owned. A 2014 report by Attorney General George Jepsen found 22 out of the 29 hospitals in the state are imposing the fees. Hospitals argue they can’t keep the doors open without charging the facility fees.

But who are they kidding?

The fee to operate a private practice doctor’s office was already included in the practice’s billing, so it is unclear why there is an additional facility fee simply because the practice is now hospital-owned. Hospitals began charging the fees in 2000 when Medicare set the standard for doctors employed by hospitals.

So, let’s call it what it is — a measure to ensure multimillion-dollar salaries and healthy profit margins.

Connecticut lawmakers roared to the challenge last year in a bid to put a $100 cap on the fees, and in certain cases bar them entirely. Some headway was made, but the bill ultimately passed is little more than a whimper. It includes banning hospital facility fees for basic outpatient community-based office visits; requiring that patients receive a notice when a practice is bought by a hospital and facility fees may be imposed; and also requires an annual report that lays out where hospitals are charging facility fees, for what services, and how much revenue the fees are generating.

These are steps in the right direction, but they don’t travel far enough. Facility fees are adding billions to the cost of health care and the ongoing expense has the potential to do serious harm as it may force people to choose between a needed doctor’s visit or their wallet.